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Technical Information Form
Please fill and send us the form as essential data for our first technical/commercial evaluation. We appreciate your co-operation.
Spaces marked with an * must be filled in.
Date:
*Company name: *Contact name: Title :
Address/ZIP: City: State :
*Telephone : Fax : *Email:
Type of appliance: Annual quantity: Actual burner:
Supplier:    
 
Allegato / Attach


Worgas Bruciatori S.r.l.
Sede Legale: Formigine (Mo) - Via Coppi, 17 - Cap 41043
Tel. +39 059 447911- Fax +39 059 574103 - P.Iva 00173220369 - email: worgas@worgas.it
Iscritta nel Registro delle Imprese di Modena al nr. 00173220369 REA nr. 141815 - C.sociale Euro 520.000 i.v.